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Saturday, 28 May 2011

Metabolic Damage Why It Happens, How to Avoid It and How to Fix It

Somewhere in your fitness travels (or random googling), you may have come across the topic of “metabolic damage” or its close relative, “starvation mode.” Perhaps both. If so, you probably felt a twinge of fear after hearing a description like this one:

star•va•tion mode - noun (stär-ˈvā-shən mōd): a series of metabolic, hormonal and behavioral responses to extreme or prolonged calorie deprivation, which is common during many popular weight loss diets. Since your body can’t recognize the difference between severe dieting and starving, it responds as if you were really starving: Protective mechanisms are activated to decrease your rate of further weight loss, including reduced energy, lower physical activity and increased appetite. Your metabolism also slows down more than you’d predict for the amount of body weight lost.

As you self-diagnose your symptoms, you really begin to worry: low energy… hungry all the time… can’t stop thinking about food... seems like you’re not losing fast enough for how little you’re eating… weight loss has gotten slower or even reached a plateau. And when returning to normal eating, you seem to gain back the weight faster and easier than you ever gained weight before!

At this point, your heart drops into the pit of your stomach and you’re convinced that you’re a metabolic damage victim. “What If I’m in starvation mode?” you ask yourself. “What if I’ve messed up my thyroid gland?” “What if I’m stuck with this fat forever because my metabolism is SHOT?”

Okay, now that I’ve scared you half to death, you can take a deep sigh of relief. Not because there’s no truth to the problems I’ve just described, but because there are solutions.

The metabolic damage and starvation mode controversies

First, I want to confirm that both “starvation mode” and “metabolic damage” are real, although some bloggers and internet writers keep insisting they’re not. The reason for the confusion is understandable though, because these phenomena are misunderstood, and myths about them abound.

The big doozy is the (mythical) girl who (claims) she’s eating “only 300 calories a day and not losing weight.” Funny how you put her in a metabolic ward on 1000-1200 calories a day (measured and enforced) and she starts losing weight like crazy. That wasn’t starvation mode caused by a 300 calorie per day “slow metabolism.” The damaging admission you’ll never hear from our physics-defying girl is, “I suck at counting calories and I underreport how much I eat…. Oh yeah, I overestimate how many calories I burn too.” [end sarcasm]

Starvation mode and metabolic damage are also not scientific terms, which is another reason they are unduly dismissed. If you look up “adaptive thermogenesis” however, (the technical term for the metabolic decrease part of starvation mode), you’ll find plenty of evidence proving that it’s real. It affects some people more than others due to genetic and lifestyle factors and it’s not a stretch to suggest that metabolic damage hits women harder than men.

Details about the mechanisms and hormones involved are beyond the scope of this article and would put 90% of my readers to sleep anyway. What’s important for now is that you understand this: starvation dieting causes rapid weight loss, but also causes “bad stuff” to happen to your body that makes continued weight loss more difficult and weight regain more likely. It’s a very complex process, involving numerous feedback loops and body systems.

The lasting effects of starvation dieting

Research dating back to the 1980’s and 1990’s found that diet-induced decreases in metabolism can extend to the period AFTER the diet is over. This gives us yet another reason why keeping the weight off is so hard.
Diane Elliot, an MD and professor of medicine at Oregon University published her research in 1989 about the lasting effects of very low calorie diets. She wrote:

In 1997, Abdul Dulloo and his colleagues at the University of Geneva completed a similar study which examined the effects of semi starvation after the calorie restriction had ended. He said:

"The reduction in thermogenesis during semistarvation persists after 12 weeks of restricted refeeding, with its size being inversely proportional to the degree of fat recovery."

In 1999, Arne Astrup published a meta analysis with data from all the studies which had investigated changes in metabolism after weight loss. They found that formerly obese subjects had a 3-5% lower resting metabolic rate than control subjects who had never been obese.

These and other studies suggest that metabolic consequences of crash dieting and rapid weight loss persist after the diet is over. The degree of metabolic drop can vary from the almost insignificant to the very serious, but the drop is real. This is “metabolic damage.” I would define it not only as the bad stuff that happens during the diet, but also as the lag time between when a severe diet ends and when your hormones, metabolic rate and appetite-regulating mechanisms get back to normal.

Pursuing weight loss the wrong way (“dumb dieting”) makes the bad stuff worse and aftereffects linger longer. Pursuing fat loss and body composition improvement the smart way minimizes the bad stuff and prevents outright metabolic damage. The Burn the Fat, Feed the Muscle (BFFM) program is based – from A to Z – on doing fat loss the smart way.

Eat more! You need a caloric deficit for weight loss, but there are different ways to do it. You can eat less. You can exercise more. You can do a little bit of both. In addition, how specifically you eat less and exercise more makes all the difference. The smart way is to avoid crash diets and pursue slower but steady fat loss with an eye on body composition. Start with a conservative deficit of only 20% below your maintenance level. Use a larger deficit only if you’re seriously overweight. Increase the deficit incrementally when you need to, ideally not going above 30% under maintenance. When you add in resistance training, cardio training and an active lifestyle, your calorie expenditure (metabolism) goes way up, and that’s how you can legitimately eat more and keep getting leaner.

1. Eat natural. The long term use of refined, artificial foods will eventually take its toll on your health. When hormonal health declines, body composition outcomes are worse during weight loss and risk of metabolic damage may increase. Furthermore, most natural, unprocessed foods, especially vegetables and lean proteins, are lower in caloric density and can lead to spontaneous decreases in caloric intake compared to the standard American diet (S.A.D.) For optimal body composition results and metabolic and hormonal health, it’s not just about calorie quantity, but also calorie quality. Don’t focus on one to the neglect of the other.

2. Eat often and regularly: I recommend eating like a physique athlete. Spread your total daily calories into 4-6 small meals per day, if feasible, and be sure to include a source of lean protein with every meal. But whatever meal schedule you choose, consistency is of great importance: studies have shown that haphazard eating patterns are at least partially responsible for metabolic disarray including decreased thermic effect of feeding and dysregulation of blood sugar and insulin

3. Use carb cycling. The Burn The Fat, Feed the Muscle Method puts you in the optimal healthy calorie deficit, but periodically, you increase your calories to keep your metabolism and appetite regulating hormones up at the normal level. Instead of the carb-phobic diets that millions of people still follow (which can actually suppress hormones like thyroid and leptin), carb cycling with a high carb refeed every 4th day or so, allows you to eat more carbs and you still keep losing fat. The benefits are physical and psychological and best part is, you’re never completely deprived.

4. Take Diet breaks: Avoid prolonged periods in aggressive caloric deficits. If you have a lot of fat to lose and it’s going to take more than 3 months to hit your long term fat loss goal, don’t do it all in one stretch. Take a week at maintenance calories after 12 weeks of restricted dieting. This – raising your calories - is the most counter-intuitive of all the metabolism-rebuilding strategies but it’s one of the most important.

5. Do Cardio. Don’t Over-Do It. If you’re overweight, you can sometimes get away with very low calorie diets without adverse consequences if you’re not doing tons of cardio on top of it. Endurance athletes get away with high volume training because they provide ample amounts of food to fuel it (man, those guys can EAT!) Dieters and physique competitors on the other hand, often semi-starve themselves while doing huge amounts of cardio at the same time.

6. Do Cardio. Don’t Over-Do It. If you’re overweight, you can sometimes get away with very low calorie diets without adverse consequences if you’re not doing tons of cardio on top of it. Endurance athletes get away with high volume training because they provide ample amounts of food to fuel it (man, those guys can EAT!) Dieters and physique competitors on the other hand, often semi-starve themselves while doing huge amounts of cardio at the same time.

Exercise research says that extreme amounts of cardio during a diet can actually cause the same type of adaptive metabolic downshift as eating too little food. Fitness and figure competitors have been known to do 2 or even 3 hours of cardio a day before competitions. This kind of overtraining can be counter-productive when you look at the metabolic damage and “cardio dependency” potential. And remember, if you’re not diligent, you can out-eat almost any amount of exercise. If you’re doing upwards of an hour of cardio a day and not seeing significant fat loss, you’d better take a close look at your diet first before you rush to add more cardio.

7. Weight training: In the physique world, weight training is a foregone conclusion. But in the everyday world of non-athletes, weight loss = “diet,” not weight loss = “lift weights.” For Suzy soccer mom, “lift weights to lose weight” probably doesn't even compute. But weight training is so important for metabolic health and better body composition, that if you were forced to choose one or the other – cardio or weights – the weightlifting would be a NO BRAINER decision. If you have a concern about metabolic damage and you’re not weight training yet, there’s nothing else to discuss. Start pumping iron, then get back to me.

What if you have long history of starvation dieting and yo yo weight cycling?

Ok, so these 7 strategies are great for avoiding metabolic damage and minimizing the metabolic adaptations that happen while dieting. But what if you’re a chronic dieter and you fear that you’ve already messed up your metabolism?

Take another sigh of relief. With the exception of a pessimistic report we see here and there about metabolic damage being irreparable, the majority of the research says the effects are temporary. In severe cases, it may take a little longer to get back to normal and continue on to achieve your long term goals, but it's never hopeless.

One case I recall was a former jazz and ballet dancer. At 5' 5", she was previously 110 lbs and had increased to about 145 or so. She didn't want to reach her previous 110, but find a happy medium of about 125 -130 lbs. I figured with at most 20 lbs to cut, this would be a simple and predictable process, but she had a challenging time dropping fat even on a surprisingly low caloric intake. I didn't know why at first – but I knew she wasn’t cheating and she was tracking food intake meticulously.

I later found out that she had been anorexic and bulimic for many years. This had lasting repercussions, and although she did reach her goal, it took about twice as long as we anticipated.

Easing into more calories and more carbs with a transitional period

If you think you’re in the same boat: (A) it seems like you’re not eating that much, but you’re not losing fat and or (B) you’ve finally reached your goal but you’re terrified of regaining if you raise your calories, you should use the same 7 strategies to get your metabolism back in gear. You simply need to add a “transition period” to build your calories back up slowly. If you’re worried about suddenly increasing your calories, you’re not paranoid – you’re prudent.

After becoming accustomed and somewhat adapted to a lower caloric intake, avoid abruptly jumping up to your predicted maintenance level. Instead, increase calories slowly 100-200 at a time and hold them there for one week. Measure the results after each one week phase, and then repeat until you reach your appropriate deficit or maintenance level. This will give your body and your mind time to adjust.

Here’s another safe way to ease into a higher food intake. This is ideal if you’ve been on a low calorie, low carb diet and you want to ease out of it. Add carbs, but start by adding them only in the post workout meal. During the post-training window of opportunity, not only will the carbs NOT get stored as fat, (they’ll get sucked right up into muscle glycogen), this strategy can dramatically improve your body composition and workout recovery.

If you still feel discouraged despite now having these strategies at your fingertips, then take one last sigh of relief. The good news is, even in extreme cases, these nutrition and training principles work! It just takes a little longer.

My dancer client? She kept going. With patience and hard work, she placed top 5 in a national fitness competition – and as you can imagine, her routine was killer, just like her body! By the way, her program included serious heavy training with free weights and she ate a lot more (clean) food than she had ever eaten before…